Department of Abdominal Radiology, Reims University Hospital, 51092 Reims, France; Department of Radiology, Cochin Hospital, AP-HP, 75014 Paris, France; Université de Paris, Faculté de Médecine, 75006 Paris, France.
Department of Abdominal Radiology, Reims University Hospital, 51092 Reims, France.
Diagn Interv Imaging. 2022 Feb;103(2):97-102. doi: 10.1016/j.diii.2021.09.009. Epub 2021 Oct 17.
The purpose of this study was to determine whether texture analysis features on pretreatment contrast-enhanced computed tomography (CT) images and their evolution can predict treatment response of metastatic skin melanoma (SM) treated with anti-PD1 monoclonal antibodies.
Sixty patients (29 men, 31 women; median age, 56 years; age range: 27-91 years) with metastatic SM treated with pembrolizumab (43/60; 72%) or nivolumab (17/60; 28%) were included. Texture analysis of SM metastases was performed on baseline and first post-treatment evaluation CT examinations. Mean gray-level, entropy, kurtosis, skewness, and standard deviation values were derived from the pixel distribution histogram before and after spatial filtration at different anatomic scales, ranging from fine to coarse. Lasso penalized Cox regression analyses were performed to identify independent variables associated with favorable response to treatment.
A total of 127 metastases were analyzed, with a median of two metastases per patient. Skewness at fine texture scale (spatial scale filtration [SSF] = 2; Hazard ratio [HR]: 3.51; 95% CI: 2.08-8.57; P = 0.010), skewness at medium texture scale (SSF = 3; HR: 0.56; 95% CI: 0.11-1.59; P = 0.014), variation of entropy at fine texture scale (SSF = 2; HR: 37.76; 95% CI: 3.48-496.22; P = 0.008) and LDH above the threshold of 248 UI/L (HR: 3.56; 95% CI: 1.78-21.35; P = 0.032] were independent predictors of response to treatment.
Pretreatment CT texture analysis-derived tumor skewness and variation of entropy between baseline and first control CT examination may be used as predictors of favorable response to anti-PD1 monoclonal antibodies in patients with metastatic SM.
本研究旨在确定预处理对比增强 CT 图像上的纹理分析特征及其演变是否可以预测接受抗 PD-1 单克隆抗体治疗的转移性皮肤黑色素瘤 (SM) 的治疗反应。
共纳入 60 例接受 pembrolizumab（43/60；72%）或 nivolumab（17/60；28%）治疗的转移性 SM 患者（29 名男性，31 名女性；中位年龄 56 岁；年龄范围：27-91 岁）。在基线和首次治疗后评估 CT 检查时对 SM 转移灶进行纹理分析。在不同的解剖尺度下（从精细到粗糙），从像素分布直方图中得出平均灰度、熵、峰度、偏度和标准差值。进行套索惩罚 Cox 回归分析，以确定与治疗反应良好相关的独立变量。
共分析了 127 个转移灶，每个患者的中位数为 2 个转移灶。在精细纹理尺度下的偏度（空间尺度滤波 [SSF] = 2；风险比 [HR]：3.51；95%置信区间：2.08-8.57；P = 0.010）、中等纹理尺度下的偏度（SSF = 3；HR：0.56；95%置信区间：0.11-1.59；P = 0.014）、精细纹理尺度下的熵变化（SSF = 2；HR：37.76；95%置信区间：3.48-496.22；P = 0.008）和 LDH 高于 248 UI/L 阈值（HR：3.56；95%置信区间：1.78-21.35；P = 0.032）是治疗反应的独立预测因子。
治疗前 CT 纹理分析得出的肿瘤偏度和基线与首次对照 CT 检查之间的熵变化可作为接受抗 PD-1 单克隆抗体治疗的转移性 SM 患者治疗反应良好的预测指标。
